Distinguishing Between Rib Nerve Pain and Heart Pain: A Guide for Young Adults

How to distinguish between intercostal neuralgia and heart pain?

Hello Doctor: I am an 18-year-old student, 179 cm tall and weighing 72 kg.
Since the beginning of this semester, I have been monitoring my pulse because my wristband shows a heart rate of 246 beats per minute while at rest, but I do not feel uncomfortable at that moment.
However, that seems unlikely.
When I measure it myself, it ranges from about 65 to 90 (I remember that anything below 100 is considered normal), right? Recently, I have been experiencing sharp or stabbing pains in my left chest area, and sometimes in my left arm near my body.
It rarely occurs on the right side.
The pain does not last long, usually not exceeding three seconds, and sometimes it lasts a bit longer, but always under ten seconds.
However, the pain is continuous.
Sometimes, deep breathing makes it hurt more, and sometimes it does not.
I am a bit worried if this could be related to heart disease.
What is the difference between heart pain and thoracic nerve pain? How can one distinguish between rib nerve pain and heart pain? If I need to see a doctor, which specialty should I consult? Additionally, what does chest tightness feel like?

Lin Yan-Cheng, 10~19 year old female. Ask Date: 2018/03/13

Dr. He Dongjin reply Cardiology

Hello, a heart rate of 246 beats per minute may indicate an issue with the wristband's detection.
Sharp or stabbing pains are often associated with neurological symptoms, and the likelihood of intercostal neuralgia is higher.
At your age, unless there is a congenital heart defect, the probability of heart problems is low.
Aside from mitral valve prolapse, you should consider visiting a cardiology clinic to check for mitral valve prolapse.
Changhua Hospital cares about your well-being.

Reply Date: 2018/03/13

More Info

Distinguishing between rib nerve pain and heart pain can be particularly challenging for young adults, especially when experiencing symptoms like chest discomfort. As an 18-year-old, it's understandable to be concerned about your health, particularly regarding potential heart issues. Let's break down the differences between rib nerve pain and heart pain, the symptoms associated with each, and what you should consider when seeking medical advice.

Understanding Rib Nerve Pain vs. Heart Pain
1. Location of Pain:
- Rib Nerve Pain: This type of pain is often localized to the chest wall and can be felt in specific areas, such as near the ribs or along the sides of the chest. It may also radiate to the back or shoulder.

- Heart Pain: Heart-related pain, often referred to as angina, is typically felt in the center or left side of the chest. It may radiate to the arms (especially the left arm), neck, jaw, or back.

2. Nature of Pain:
- Rib Nerve Pain: This pain can be sharp, stabbing, or aching. It may worsen with certain movements, deep breaths, or palpation of the affected area. The pain is often brief, lasting seconds to a few minutes.

- Heart Pain: Heart pain may feel like pressure, squeezing, fullness, or a heavy weight on the chest. It can last longer and may be accompanied by other symptoms such as shortness of breath, sweating, nausea, or dizziness.

3. Triggers:
- Rib Nerve Pain: Often related to physical activity, poor posture, or injury. It may be exacerbated by movements that involve the upper body or deep breathing.

- Heart Pain: Can occur during physical exertion or emotional stress but may also happen at rest. Factors like heavy meals, extreme temperatures, or intense emotions can also trigger heart-related pain.

4. Associated Symptoms:
- Rib Nerve Pain: May be associated with muscle spasms, tenderness in the chest wall, or pain that increases with movement.

- Heart Pain: Often accompanied by other systemic symptoms such as palpitations, cold sweats, or feelings of impending doom.

When to Seek Medical Attention
Given your age and the fact that you have been monitoring your heart rate, it’s important to consult a healthcare professional if you experience:
- Persistent or worsening chest pain.

- Pain that radiates to other areas (like the arm or jaw).

- Accompanying symptoms such as shortness of breath, excessive sweating, or dizziness.

- Any significant changes in your heart rate, especially if your device shows an unusually high pulse rate without any physical activity.

What to Expect at the Doctor's Office
If you decide to see a doctor, it would be best to visit a cardiologist or a primary care physician who can evaluate your symptoms. They may perform:
- An electrocardiogram (ECG) to assess your heart's electrical activity.

- A physical examination to check for tenderness in the chest wall.

- Additional tests, such as a chest X-ray or echocardiogram, if necessary.

Understanding Chest Tightness
As for your question about chest tightness, it can feel like a sensation of pressure or constriction in the chest. It may be related to anxiety, muscle tension, or even gastrointestinal issues. If you experience this sensation frequently, it’s worth discussing with your healthcare provider.

Conclusion
In summary, while rib nerve pain and heart pain can present similarly, there are distinct differences in their characteristics and associated symptoms. Given your concerns and the symptoms you’ve described, it’s advisable to seek medical evaluation to rule out any serious conditions and to gain peace of mind. Remember, it’s always better to err on the side of caution when it comes to your health.

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